Hemodialysis
A machine filters your blood outside the body, usually three times a week at a dialysis center, or at home.
Kidney education
Understanding your illness takes away some of the fear of the unknown. Here are the words you will hear, and the choices you have.
How healthy kidneys work
Your kidneys are your body's cleaning system
Most people have two kidneys, each about the size of a fist, just below the rib cage on either side of the spine.
- Blood comes in. Blood carrying waste and extra water flows into the kidney.
- Tiny filters clean it. Each kidney has about a million tiny filters that sort out what your body needs and what it does not.
- Clean blood goes back. The cleaned blood returns to the rest of your body.
- Waste leaves as urine. Waste and extra water travel down to the bladder and leave the body when you urinate.
Kidneys also help control blood pressure, keep your bones strong, and tell your body to make red blood cells. When kidneys are damaged, waste and fluid build up, which is why people with kidney failure need dialysis or a transplant to do this work for them.
The stages of chronic kidney disease
Doctors use a blood test called eGFR to measure how well your kidneys filter. The higher the number, the better. Kidney disease is grouped into five stages. Many people live for years in the early stages, especially when diabetes and blood pressure are well controlled.
Treatment options
There is more than one way to treat kidney failure. Talk with your care team about which fits your health, home and daily life.
Hemodialysis
Usually done at a dialysis center three times a week, about four hours each time. Some people do it at home.
- Blood leaves your body through your access, a special connection usually in your arm.
- The dialyzer cleans it. This filter, often called an artificial kidney, removes waste and extra fluid.
- Clean blood returns to your body through a second needle. Only a small amount of blood is outside your body at any time.
Peritoneal dialysis (PD)
Done at home every day. The lining of your belly, called the peritoneum, works as the filter.
- Cleaning fluid flows in through a soft tube (a catheter) placed in your belly.
- Waste moves into the fluid. While the fluid sits inside, waste and extra water pass from your blood into it.
- Used fluid drains out, and fresh fluid goes in. This is called an exchange. With CAPD you do it by hand; with CCPD a machine does it at night.
CAPD
Continuous ambulatory peritoneal dialysis. The lining of your belly filters your blood. You change the fluid by hand several times a day.
CCPD
Continuous cycling peritoneal dialysis. A machine changes the fluid for you at night while you sleep.
Kidney transplant
A healthy kidney from a living or deceased donor takes over the work. Your care team can explain whether you are eligible.
Types of access for hemodialysis
An access is the place on your body where blood is taken out and returned during hemodialysis. It is usually made with a small surgery weeks or months before you start.
Arteriovenous (AV) fistula
A surgeon joins an artery and a vein, usually in your arm. It needs time to heal before use, but it tends to last longest and has fewer infections.
Arteriovenous (AV) graft
A soft tube connects an artery and a vein. It can be used sooner than a fistula, and is an option when veins are small.
Catheter
A tube placed in a large vein, often in the neck or chest. It is usually used for a short time while a fistula or graft heals.
Living well on dialysis
Small daily habits make a big difference. Your dietitian and care team will give you limits that are right for you.
Keep every treatment
Skipping or shortening dialysis lets waste and fluid build up quickly. If you feel unwell or cannot make a session, call your dialysis center right away.
Watch your fluids
Your care team will tell you how much to drink each day. Anything liquid at room temperature counts, including soup, ice and gelatin.
Go easy on salt
Less salt means less thirst, easier fluid control and better blood pressure. Fresh foods usually have less salt than canned or packaged ones.
Know your potassium and phosphorus
Ask what your lab results mean. Your dietitian can show you which foods to limit, and if you take a phosphate binder, take it with meals as prescribed.
Protect your access
Keep your access clean, check it every day as your care team showed you, and do not allow blood pressure cuffs, tight sleeves or needles on that arm.
Stay active and connected
Gentle activity that your doctor approves helps your energy and mood. Talking with others who understand, like at our Hang-Out, helps too.
Learning videos
Short videos for anyone just starting out. Watch them with your family.
Video coming soon
How your kidneys work
A short introduction for anyone newly diagnosed.
Video coming soon
What to expect at your first dialysis treatment
What happens before, during and after a hemodialysis session.
Video coming soon
Peritoneal dialysis at home
How exchanges work and what a day on PD looks like.
Words you will hear
- Kidneys
- Two bean-shaped organs just below the rib cage, one on each side of the spine. They remove waste and extra water from the blood as urine, keep the body's water and minerals in balance, help control blood pressure, and help the body make red blood cells.
- Creatinine
- A waste product made by normal muscle activity. It is measured in blood and urine tests to check how well the kidneys are working.
- BUN (Blood Urea Nitrogen)
- A blood test that measures urea, a waste product the kidneys filter out. A high level can mean the kidneys are not working well.
- eGFR
- Estimated glomerular filtration rate. A number calculated from your creatinine that shows how well your kidneys filter. It is used to tell the stage of kidney disease.
- Anemia
- A condition in which your body does not have enough red blood cells. A low hemoglobin level can be a sign of anemia. It is common in kidney disease.
- Hematocrit
- A way of measuring the red blood cell content of the blood, shown as a percentage of the total blood.
- Diabetes
- A condition in which the body does not make enough insulin or cannot use it well, so blood sugar (glucose) stays too high. It is a leading cause of kidney failure.
- Hypertension
- High blood pressure. Over time it can damage the small blood vessels in the kidneys. It is the other leading cause of kidney failure.
Who is at risk
Anyone can develop kidney disease, but the risk is higher if you have diabetes, high blood pressure, heart disease, or a family history of kidney failure. African Americans are more likely to develop kidney disease because of diabetes and hypertension. Early kidney disease often has no symptoms, so a simple blood and urine test is the best way to find it early.
Early screening is the key to prevention.
Want to learn more? See our helpful links to trusted kidney organizations, or bring your questions to our monthly meeting.
This information is for education only and is not medical advice. Always talk with your doctor, nurse or dialysis care team about your own health and treatment.